What is Intercostal Neuralgia? Symptoms, Causes, Treatment

Learn all about intercostal neuralgia, symptoms, causes and treatments related to this nervous disorder. Neuralgia is a medical term that defines pain. Intercostal neuralgia is caused by nerve compression in the thoracic/abdominal area (ribcage area). Intercostal neuralgia is often confused with multiple cardiovascular diseases.

There are many types neuralgia, one of which is Intercostal Neuralgia. This is caused due to compression of nerve in thoracic or the abdominal area i.e., the ribcage. Intercostal Neuralgia is a rare condition in which there is pain along the intercostal nerves. These nerves lie between the ribs and any sort of damage to one of the nerves or any loss of function of nerve results in intercostal neuralgia.

Peripheral nerve damage can cause intercostal neuralgia. The majority of patients feel pain associated with this condition in the upper chest muscles, under the arm and around to the back of the scapula or shoulder blade. Pain often is intermittent, but makes the touch of cloth, skin pressure and normal daily activities such as sitting or lying difficult and painful.

Intercostal neuralgia is often associated with injury or inflammation of the nerves, muscles, cartilage and ligaments in the rib cage and middle spine area. Common causes of intercostal neuralgia include pregnancy, tumors, chest or rib injury, surgery to the chest or organs in the chest cavity, and shingles. Shingles can attack nerves in the chest and upper back. In patients who had a thoracotomy surgery, they may experience pain that radiates along the rib cage or just experience persistent pain along the incision site. The description of the pain is similar, and it may be severe and debilitating.

Spasmodic, lightening-like pain in the rib-cage area, along with other symptoms like decreased appetite, back and side pain and numbness or tingling could be symptoms of intercostal neuralgia. Treatments for intercostal neuralgia are similar to those for sciatica. Analgesics, nonsteroidal anti-inflammatory drugs, blood thinners, weight loss and patient education are some of the predominant treatments. Injecting a local anesthetic, such as Xylocaine or Lidocaine, into the area has had some success but should be done only is a licensed physician. In certain cases, the nerve that is generating the pain must be destroyed. In cases of scar tissue, the tissue must be excised to free the nerve and release pressure.

What is Intercostal Neuralgia?

Intercostal neuralgia is a painful disorder of the nerves that run between the ribs, and is caused by damage to one of the nerves and/or loss of function of the nerve. Intercostal muscles are those that connect the rib cage and help hold the chest wall together. When you strain or pull one of these muscles, you may experience difficulty breathing or expanding the chest, as well as difficulty or pain when twisting, turning or bending. Intercostal neuralgia may be preventable and is often treatable. The intercostal areas between the ribs contain muscles and nerves. These intercostal nerves can become damaged or inflamed due to a variety of diseases, disorders and conditions, resulting in intercostal neuralgia.

Intercostal Neuralgia Symptoms

The first symptom of intercostal neuralgia may be considered pain in the ribs, which is due to irritation or compression of the intercostal nerves. According to the nature of the pain it can be different in feeling: burning, sharp, aching, or dull. According to the periodicity the pain can be both episodic and constant. The pain can be dramatically intensified if any, even minor physical activity, or simply an unexpected movement, for example, a sharp body movement, cough or sneeze. Intercostal neuralgia may involve other symptoms including:
• Abdominal pain
• Fever
• Itchiness
• Numbness
• Pain in your arm, shoulder or back
• Restricted mobility of your shoulders or back
• Tingling

Intercostal Neuralgia Causes

Here are some common causes that are associated with intercostal neuralgia,
• Direct injury or trauma to the rib cage can result in damage to the underlying nerve, resulting in intercostal neuralgia.
• Degenerative disease of the nerves can result in pinching and damaging of the nerves, resulting in intercostal neuralgia.
• Nutritional deficiencies, especially those of vitamin B12 can cause the nerves to become highly sensitive and result in neuralgia.
• Entrapment of intercostal nerves.
• Neuritis.
• Pregnancy, which causes rib cage to expand in order to make room for fetus.
• Strain to the muscles of chest wall, shoulders, or back.
• Rib infections.
• Shingles.
• Surgical procedure in and around the thoracic cavity can lead to intercostal neuralgia.
• Intercostal neuralgia can be caused due to tumors around the chest or abdomen pressing on intercostal nerves.

Intercostal Neuralgia Treatment

Intercostal neuralgia can also resolve on its own but generally requires treatment. Treatment options include medicines and surgery:
• Intercostal nerve blocks, which are injections of a local anesthetic or a corticosteroid around the affected intercostal nerve
• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) naproxen (Naprosyn, Aleve), and indomethacin (Indocin). NSAIDS help reduce inflammation and pain.
• Medications that may be used to treat shingles include:
• Antidepressant medications, which can help reduce nerve pain
• Antihistamines, which relieve itching
• Antiviral medications, such as acyclovir (Zovirax) and famciclovir (Famvir). Antiviral medications may reduce the severity and duration of your symptoms.
• Capsaicin cream (Zostrix), which helps relieve pain
• Corticosteroids

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